中国实用外科杂志

中国实用外科杂志 ›› 2008, Vol. 28 ›› Issue (07): 550-552.

• 论著 • 上一篇    下一篇

乳腺小细胞神经内分泌癌（附3例报告）

崔明，张霁，冷家骅，苏向前，王怡   

  1. 北京大学临床肿瘤学院北京肿瘤医院暨北京市肿瘤防治研究所综合外科，北京100036
  • 收稿日期:2008-02-25 修回日期:2008-03-09 出版日期:2008-06-24 发布日期:2008-06-24

Small cell neuroendocrine carcinoma of the breast:a clinical and pathological analysis of 3 cases

<a href="https://www.zgsyz.com/zgsywk/EN/article/advancedSearchResult.do?searchSQL=(((CUI Ming[Author]) AND 1[Journal]) AND year[Order])" target="_blank">CUI Ming</a>,<a href="https://www.zgsyz.com/zgsywk/EN/article/advancedSearchResult.do?searchSQL=(((ZHANG Ji[Author]) AND 1[Journal]) AND year[Order])" target="_blank">ZHANG Ji</a>,<a href="https://www.zgsyz.com/zgsywk/EN/article/advancedSearchResult.do?searchSQL=(((LENG Jia-hua[Author]) AND 1[Journal]) AND year[Order])" target="_blank">LENG Jia-hua</a>,<a href="https://www.zgsyz.com/zgsywk/EN/article/advancedSearchResult.do?searchSQL=(((et al.[Author]) AND 1[Journal]) AND year[Order])" target="_blank">et al.</a>   

  1. Department of Surgical Oncology,Peking University School of Oncology,Beijing Cancer Hospital ＆ Institute,Beijing 100036,China
  • Received:2008-02-25 Revised:2008-03-09 Online:2008-06-24 Published:2008-06-24

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摘要：

目的:探讨乳腺小细胞神经内分泌癌的临床诊断和治疗。方法:回顾性分析北京大学临床肿瘤学院2001年1月至2006年6月收治的3例乳腺小细胞神经内分泌癌的临床表现、病理、治疗及预后。结果:3例乳腺小细胞神经内分泌癌均以自行发现乳腺肿物就诊。钼靶示病灶内无钙化。2例行保乳术,1例行改良根治术。病理检查具有小细胞癌的形态学特点，免疫组织化学染色结果突触素（Syn）（++）、嗜铬颗粒蛋白A（CgA）（++）3例，神经元特异性烯醇化酶（NSE）（+）1例，雌激素受体（ER）、孕激素受体（PR）和人表皮生长因子受体2（HER2）均为阴性。随访时间9～74个月，无淋巴结转移1例，术后无病存活74个月；淋巴结转移2例，术后1年内均出现全身多发转移，其中1例存活期15个月，1例术后9个月尚存活。结论乳腺小细胞神经内分泌癌十分罕见。无钙化，雌激素受体（ER）、孕激素受体（PR）和HER2表达阴性可能是该病的临床特点。确诊需依靠病理形态学及免疫组织化学染色。目前治疗效果及预后差异较大，提示该病可能具有不同的亚型。

关键词: 乳腺小细胞, 神经内分泌肿瘤

Abstract:

Objective:To analyze the features of clinical diagnosis and treatment of small cell neuroendocrine carcinoma of the breast. Methods:Three cases of breast small cell neuroendocrine carcinoma were admitted between January 2001 and June 2006 in Peking University School of Oncology.Their clinical and pathological data,treatment and prognosis were analyzed retrospectively. Results:All the three lesions were palpable and were found by the patients themselves. Mammography showed no calcification in any of the three lesions.Breastconserving surgery was performed in 2 patients,and modified radical mastectomy in 1 patient. All the patients were diagnosed small cell neuroendocrine carcinoma pathologically. Immunohistochemical results showed Syn（++） and CgA（++） in 2 patients and NSE (+) in 1 patient.Expression of ER,PR and Her2 were negative in all patients.Followup ranged from 9 to 74 months.One patient with no lymph node metastasis was still alive without relapse and metastasis 74 months after the treatment.Multiple metastasis were revealed in 2 patients with lymph node metastasis within 12 months after diagnosis.One died within 15 months after excision.The other had survived for 9 months after excision. Conclusion:Small cell neuroendocrine carcinoma is rare neoplasms of the breast.No calcification and negative expression of ER,PR and Her2 might be the characteristics of the disease.Diagnosis of the disease should depend on pathological results.Significant differences of prognosis and curative effect of treatments suggest that the disease may have subtypes.

Key words: breast small cell, neuroendocrine neoplasm